X12 837 QUICKLINK PROFESSIONAL FRONT-END VALIDATION ...

Level 4 – IMPLEMENTATION GUIDE (IG) EDITSIG0025IG0026IG0027IG0031IG0032IG0033IG0034IG0035IG0036IG0037IG0038IG0039IG0041IG0047IG0048IG0049IG0053IG0054IG0055IG0056IG0057IG0058IG0059IG0060LOOP 2330G REF MISSING, REQUIRED WHEN LOOP 2330G, NM1 PRESENTLOOP 2330H REF MISSING, REQUIRED WHEN LOOP 2330H, NM1 PRESENTLOOP 2400 LX01: START WITH 1/ INCREMENT BY 1 FOR EACH NEW LXThe Service Line LX segment begins with 1 and is incremented by one for each additional serviceline within the claim. The LX functions as a line counter.PATIENT HL 23 MISSING, REQUIRED IF LOOP 2000B SBR02 IS NOT PRESENTLOOP 2000C PAT MISSING, REQUIRED WHEN PATIENT HL 23 IS PRESENTLOOP 2010CA NM1 MISSING, REQUIRED IF PATIENT HL 23 IS PRESENTLOOP 2010CA N3 MISSING, REQUIRED IF LOOP 2010CA NM1 PRESENTLOOP 2010CA N4 MISSING, REQUIRED IF LOOP 2010CA NM1 PRESENTLOOP 2010CA DMG MISSING, REQUIRED WHEN LOOP 2010CA NM1 PRESENTLOOP 2320 OI MISSING, REQUIRED WHEN LOOP 2320, SBR PRESENTLOOP 2400 LX SEGMENT (SERVICE LINE NUMBER) IS MISSINGLOOP 2300 PWK02 =BM/EL/EM/FX, PWK05 MISSINGLOOP 2300 CLM SEGMENT (CLAIM INFORMATION) IS MISSINGDUPLICATE ST02-TRANSACTION SET CONTROL NUMBER WITHIN ISA - IEALOOP 2300 PWK02 =BM/EL/EM/FX, PWK06 MISSINGLOOP 2430 SVD01 MUST MATCH 2330B, NM109 OTHER PAYER IDIF LOOP 2010BA NM108=MI, 2010BA REF01 CAN NOT EQUAL 1WLOOP 2010BC N3 MISSING, REQUIRED WHEN LOOP 2010BC NM1 PRESENTLOOP 2010BC N4 MISSING, REQUIRED WHEN LOOP 2010BC NM1 PRESENTNM101 ERROR, LOOP NOT RECOGNIZED, A PRIOR LOOP ID ASSIGNEDThe NM1 segments are critical segments and identify the beginning of a loop. If the value inNM101 does not equal a value within the implementation guide, translation within the affectedloop will be impacted. If the loop can not be determined, a default to the first occurrence of theloop series will occur. For example, if an 837 interchange had an 2310A with NM101 =71 and theloop following had a NM101 with a value of 01 which is valid for the standard and invalid for theimplementation guide, we will assign a loop 2310A since the A is the first occurrence of that loopseries. Segment count location on the receipt report may not match the 837 input location due tothe assignment of the default loop.CLM09 NOT EQUAL ‘N’, CLM10 IS REQUIREDCLM11-1, -2, -3 = AA, AB, AP OR OA, 2300 DTP01=439 REQUIREDSee Critical IG Edits section2000B OR 2000C PAT09 = Y, 2300 DTP01=484 REQUIREDEMC Front End Validation – Quicklink Commercial Professional 4010A137